Psychiatry Research
March 1, 2025
Stephanie L. Haft, Amanda E. Downey, Marissa Raymond-Flesch et al.
22 citations
A systematic review of 21 randomized controlled trials of psilocybin- and MDMA-assisted therapies (total 1034 participants) found that participant samples lack diversity. Gender was always reported, race or ethnicity in 76% of trials, and socioeconomic status in 57%. Sexual orientation (9.5%) and immigration status (4.8%) were rarely reported; no study reported gender identity. Compared to the US population and non-psychedelic clinical trials, Black/African-American participants (2.2%) and Hispanic/Latino participants (7.2%) were significantly underrepresented. MDMA trials enrolled more diverse samples than psilocybin trials. Analyses of treatment effects by demographic variables were virtually absent. The findings indicate a need for inclusive recruitment and rigorous reporting to improve generalizability.
Journal of Eating Disorders
April 24, 2024
Amanda E. Downey, Anita V. Chaphekar, Joshua Woolley et al.
13 citations
Clinical trials are testing psilocybin therapy for anorexia nervosa (AN), but individuals with AN have unique medical vulnerabilities. This review describes how common physiologic adverse effects of psilocybin—tachycardia, hypertension, electrocardiogram changes, nausea, headache, and lightheadedness—may interact with medical complications seen in AN. It proposes risk mitigation strategies for each adverse effect. Early evidence suggests psilocybin therapy is well-tolerated in individuals with AN. Understanding AN's medical complications in relation to psilocybin's effects can help tailor strategies to enhance safety and tolerability of this novel intervention.
International Journal of Eating Disorders
August 8, 2023
Maxine Boyd, Joshua Woolley, Amanda E. Downey et al.
7 citations
Healthcare providers who treat eating disorders expressed interest in psilocybin-assisted psychotherapy but raised concerns about risks to malnourished patients and those with psychological comorbidities. In focus groups with 32 participants, providers also worried about equity in access for publicly insured and non-English speaking patients. They requested continuing education about psilocybin therapy. Despite concerns, providers were hopeful about psilocybin therapy as a treatment and valued collaboration to improve long-term patient outcomes as clinical trials develop.
Child and Adolescent Psychiatry and Mental Health
June 4, 2025
Sarah Forsberg, Amanda E. Downey, Lindsey D Bruett et al.
5 citations
Psychedelic-assisted therapy is gaining interest for treating mental health conditions in adolescents, but safe and effective delivery requires careful consideration of caregiver involvement. Caregivers are essential in adolescent mental health treatment, supporting recovery and disrupting illness-maintaining patterns, while also needing resources to manage caregiving challenges. This review synthesizes evidence from adolescent mental health treatments, PAT best practices, and family systems theory to propose a framework for integrating caregivers into adolescent PAT. The family system is a critical setting that may shape PAT efficacy, analogous to the therapeutic setting (set and setting). Recommendations are provided for incorporating caregivers into PAT protocols to maximize safety and efficacy.
FOCUS The Journal of Lifelong Learning in Psychiatry
July 1, 2024
Sasha Gorrell, Amanda E. Downey
3 citations
Medications have shown little success in improving eating disorder cognitions, and many patients do not benefit from evidence-based psychotherapies. Anorexia nervosa is becoming more common and remains difficult to treat. This article reviews early research into cannabidiol, psilocybin therapy, ketamine, the ketogenic diet, transcranial magnetic stimulation, and vagus nerve stimulation for anorexia nervosa. These pilot studies highlight the need for larger, more diverse clinical trials to move findings into clinical practice.
American Journal of Psychiatry
December 1, 2025
Amanda E. Downey, Marlene Tai, Ellen Bradley et al.
2 citations
Psilocybin, a hallucinogen found in certain mushrooms, shows promise in treating severe depression, with studies revealing that 70% of participants experienced significant symptom reduction after just one dose. In a sample of 200 individuals, those receiving psilocybin reported enhanced consciousness and emotional well-being compared to a control group. Additionally, the safety profile is encouraging; there were no incidents of sudden death or severe adverse effects linked to ingestion. This highlights psilocybin's potential role in modern psychiatry as a transformative medicine alongside cannabis and cannabinoid research.
Psychedelic Medicine
February 28, 2024
Joshua Woolley, Amanda E. Downey, Ellen Bradley et al.
2 citations
A risk stratification tool is proposed to help decide whether individuals with a family history of bipolar disorder should be included in psilocybin therapy trials. The authors argue for caution due to the potential for serious adverse events, but they recommend against outright exclusion. The tool allows for more nuanced inclusion and exclusion criteria, balancing the need for effective treatments against safety concerns.
August 25, 2024
Stephanie L. Haft, Amanda E. Downey, Marissa Reymond-Flesch et al.
1 citation
preprint
Limited participant diversity in mental health intervention research perpetuates health disparities, a concern especially relevant to psychedelic-assisted psychotherapy (PAT). This systematic review of 21 randomized controlled trials of psilocybin- and MDMA-assisted therapies (total 1,034 participants) found that gender (100%) and race or ethnicity (76%) were frequently reported, while socioeconomic status was sometimes reported (57%) using varied measures. Sexual orientation (9.5%) and immigration status (4.8%) were rarely reported, and no studies reported gender identity. Black/African-American (12.2%) and Hispanic/Latino (7.2%) participants were significantly underrepresented compared to the US population and non-psychedelic clinical trials. MDMA trials enrolled more diverse samples than psilocybin trials. Analyses of treatment effects by sociodemographic variables were virtually nonexistent, highlighting the need for inclusive recruitment and rigorous reporting to improve generalizability.
Current Psychiatry Reports
May 14, 2026
Jamarie Geller, Rachel M Pacilio, Amanda E. Downey et al.
Psilocybin-assisted therapy may hold promise for anorexia nervosa, a serious and often treatment-resistant illness. Although research has focused on adults, anorexia frequently begins in adolescence, and early onset is linked to more severe illness, greater psychiatric comorbidity, and more life difficulties. The authors argue that exploring the theoretical potential of this therapy for adolescents is warranted, considering biological implications, developmental stage, and consent. They propose adaptations to adult treatment models and discuss emerging models that address the unique challenges of adolescent patients.
Journal of the American Academy of Child & Adolescent Psychiatry
October 1, 2023
Amanda E. Downey
No Summary